Phys Clinical Cases · infectious
Viral Hepatitis — DCE Clinical Case
DCE short-case station: examine this patient's abdomen — the chronic liver disease and portal hypertension examination in a patient with chronic viral hepatitis, a presentation template, and the surveillance-focused discussion that follows.
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Prompt
DCE short-case station: examine this patient's abdomen — the chronic liver disease and portal hypertension examination in a patient with chronic viral hepatitis, a presentation template, and the surveillance-focused discussion that follows.
The instruction decoded
"Examine the abdomen" in a viral hepatitis patient is really three tasks: demonstrate the stigmata of chronic liver disease, demonstrate the signs of portal hypertension, and then — the physician's flourish — examine for the complications and the cause, and land on a management synthesis, not a sign list [1] [2].
References5ShowHide
- [1]Terrault NA, Lok ASF, McMahon BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance Hepatology, 2018.PMID 29405329
- [2]Marrero JA, Kulik LM, Sirlin CB, et al. Diagnosis, Staging, and Management of Hepatocellular Carcinoma: 2018 Practice Guidance by the American Association for the Study of Liver Diseases Hepatology, 2018.PMID 29624699
- [3]Yim HJ, Lok AS. Natural history of chronic hepatitis B virus infection: what we knew in 1981 and what we know in 2005 Hepatology, 2006.PMID 16447285
- [4]European Association for the Study of the Liver. EASL recommendations on treatment of hepatitis C: Final update of the series(☆) J Hepatol, 2020.PMID 32956768
- [5]Stravitz RT, Lee WM. Acute liver failure Lancet, 2019.PMID 31498101